Genomic characterization of Plasmodium falciparum genes associated with anti-folate drug resistance and treatment outcomes in eastern India: A molecular surveillance study from 2008 to 2017

• DOI: 10.3389/fcimb.2022.865814
• Publication Date: 2022-12-13T05:49:53Z
• Authors: Sabyasachi Das; Satyajit Tripathy; Ankita Das; Meenakshi Kumari ...; Ayan Nag; Amiya Kumar Hati; Somenath Roy
• Keywords: Sulfadoxine/pyrimethamine; DHPS; Sulfadoxine; Dihydropteroate synthase

Introduction After being used vigorously for the previous two decades to treat P. falciparum, chloroquine and sulfadoxine-pyrimethamine were replaced in 2009 with an artemisinin-based combination therapy (artesunate-sulfadoxine-pyrimethamine) effort combat multidrug-resistant parasites. Methods We set out assess genetic variants of resistance effectiveness its treatment eastern India prior to, during, 6 8 years following introduction new pharmacological regime. In 2008-2009, 318 falciparum–positive patients got recommended doses sulfadoxine-pyrimethamine. 379 additional isolates from 2015 2017 addition 106 2010. All 803 study sites underwent vitro sensitivity testing genomic characterisation (pfdhfr pfdhps). Results Kolkata Purulia, we observed early failure 30.7 14.4% patients, respectively, whereas recrudescence was found 8.1 13.4% 2008–2009. 2017, proportion pyrimethamine sulfadoxine steadily grew Purulia despite a single use Treatment failures linked quintuple or quadruple pfdhfr- pfdhps mutations (AICII-AGKAT, AICII-AGKAA, AICII-SGKGT, AICNI-AGKAA) 2008–2009 (p < 0.001). The subsequent spread mutant-haplotypes higher 0.001), such as sextuple (dhfr-AIRNI+dhps-AGEAA, dhfr-ANRNL+dhps-AGEAA) septuple (dhfr-AIRNI+dhps-AGEAT), 2015-2017. Discussion This successive high confirmed progressive increase antifolate even after 8-year withdrawal